Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.66 / $2,291.00 / $18,711.00	Facility		$149.66	$2,291.00	$18,711.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.09 / $210.15 / $499.78	Professional		$80.09	$210.15	$499.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $116.09 / $630.38 / $630.38	Professional	50	$116.09	$630.38	$630.38
Asuris Northwest Health Facility/Professional Facility Modifier Low / Median / High Price $213.02 / $1,836.95 / $3,748.81	Facility		$213.02	$1,836.95	$3,748.81
Asuris Northwest Health Facility/Professional Facility Modifier 50 Low / Median / High Price $2,285.07 / $2,939.66 / $5,687.07	Facility	50	$2,285.07	$2,939.66	$5,687.07
Asuris Northwest Health Facility/Professional Facility Modifier 52 Low / Median / High Price $170.42 / $299.14 / $299.14	Facility	52	$170.42	$299.14	$299.14
Asuris Northwest Health Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $409.59 / $1,886.00	Professional		$143.91	$409.59	$1,886.00
Asuris Northwest Health Facility/Professional Professional Modifier 50 Low / Median / High Price $241.80 / $249.56 / $670.50	Professional	50	$241.80	$249.56	$670.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $714.97 / $870.49 / $880.53	Facility		$714.97	$870.49	$880.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.82 / $245.04 / $629.27	Professional		$105.82	$245.04	$629.27
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $106.47 / $260.83 / $660.80	Facility		$106.47	$260.83	$660.80
Kaiser Permanente Facility/Professional Facility Modifier 50 Low / Median / High Price $1,928.64 / $2,377.07 / $5,719.21	Facility	50	$1,928.64	$2,377.07	$5,719.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $106.47 / $247.82 / $593.26	Professional		$106.47	$247.82	$593.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $350.02 / $622.50	Professional		$64.84	$350.02	$622.50
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $164.15 / $405.35 / $446.22	Facility		$164.15	$405.35	$446.22
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.70 / $304.36 / $380.45	Facility		$126.70	$304.36	$380.45
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $272.42 / $551.78	Professional		$137.93	$272.42	$551.78
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $1,443.99 / $1,959.77 / $3,748.81	Facility		$1,443.99	$1,959.77	$3,748.81
Regence BlueShield Facility/Professional Facility Modifier 50 Low / Median / High Price $2,165.98 / $2,939.66 / $5,623.22	Facility	50	$2,165.98	$2,939.66	$5,623.22
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $130.32 / $267.01 / $524.92	Professional		$130.32	$267.01	$524.92
United Facility/Professional Facility Modifier Low / Median / High Price $472.00 / $938.00 / $4,611.00	Facility		$472.00	$938.00	$4,611.00
United Facility/Professional Professional Modifier Low / Median / High Price $260.14 / $350.90 / $639.15	Professional		$260.14	$350.90	$639.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $86.99 / $180.55 / $247.60	Professional		$86.99	$180.55	$247.60